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Metachronous contralateral pediatric inguinal hernia
RM Nataraja,AA Mahomed
Open Access Surgery , 2010,
Abstract: RM Nataraja, AA MahomedDepartment of Pediatric Surgery and Urology, Royal Alexandra Children’s Hospital, Brighton, UKDate of preparation: April 20, 2010. Conflict of interest: None declaredClinical question: Should routine contralateral inguinal region exploration be done to prevent a metachronous contralateral pediatric inguinal hernia?Results: The incidence of a metachronous contralateral pediatric inguinal hernia is 6.4% in both genders. Sixteen contralateral groin explorations need to be done to prevent one metachronous contralateral pediatric inguinal hernia.Implementation: Routine exploration of the asymptomatic contralateral groin is not recommended. Infants less than one month old with an inguinal hernia should receive immediate specialist referral. Older infants and children with a reducible hernia should be referred to the pediatric surgical outpatient department. Pediatric patients with an original left-sided hernia or who were less than six months old at the time of the first hernia repair should receive regular follow-up in the primary health care setting.Keywords: metachronous contralateral pediatric inguinal hernia, exploration
Metachronous contralateral pediatric inguinal hernia
RM Nataraja, AA Mahomed
Open Access Surgery , 2010, DOI: http://dx.doi.org/10.2147/OAS.S11907
Abstract: achronous contralateral pediatric inguinal hernia Evidence to Practice (3457) Total Article Views Authors: RM Nataraja, AA Mahomed Published Date August 2010 Volume 2010:3 Pages 87 - 90 DOI: http://dx.doi.org/10.2147/OAS.S11907 RM Nataraja, AA Mahomed Department of Pediatric Surgery and Urology, Royal Alexandra Children’s Hospital, Brighton, UK Date of preparation: April 20, 2010. Conflict of interest: None declared Clinical question: Should routine contralateral inguinal region exploration be done to prevent a metachronous contralateral pediatric inguinal hernia? Results: The incidence of a metachronous contralateral pediatric inguinal hernia is 6.4% in both genders. Sixteen contralateral groin explorations need to be done to prevent one metachronous contralateral pediatric inguinal hernia. Implementation: Routine exploration of the asymptomatic contralateral groin is not recommended. Infants less than one month old with an inguinal hernia should receive immediate specialist referral. Older infants and children with a reducible hernia should be referred to the pediatric surgical outpatient department. Pediatric patients with an original left-sided hernia or who were less than six months old at the time of the first hernia repair should receive regular follow-up in the primary health care setting.
Ultrasound Prenatal Diagnosis of Inguinal Scrotal Hernia and Contralateral Hydrocele  [PDF]
G. Massaro,G. Sglavo,A. Cavallaro,G. Pastore,C. Nappi,C. Di Carlo
Case Reports in Obstetrics and Gynecology , 2013, DOI: 10.1155/2013/764579
Abstract: Fetal inguinal scrotal hernia is a rare condition resulting in an abnormal embryonic process of the tunica vaginalis. We report a case of ultrasound prenatal diagnosis of inguinal scrotal hernia associated with contralateral hydrocele in a woman at 37 weeks of gestation, referred to our clinic for a scrotal mass. Differential diagnosis includes hydrocele, teratoma, hemangiomas, solid tumours of testis, bowel herniation, and testicular torsion. Bowel peristalsis is an important ultrasound sign and it allowed us to make diagnosis of inguinal scrotal hernia. Diagnosis was confirmed at birth and a laparoscopic hernia repair was performed without complications on day 10. During surgery, a bilateral defect of canal inguinal was seen and considered as the cause of scrotal inguinal hernia and contralateral hydrocele observed in utero. 1. Introduction Inguinal hernia is found in 1–4% of neonates and children. It is more common in male and is usually an isolated finding. Pediatric inguinal hernias and hydroceles are due to incomplete or abnormal obliteration of the processus vaginalis peritonei [1–3]. This is a tubular fold of the peritoneum that invaginates into the inguinal canal anterior to the gubernaculum and descending testis, ending in the scrotum. The upper part usually closes at or just before birth, and obliteration proceeds gradually in a downward direction. The scrotal section remains patent, forming the tunica vaginalis testis [2]. If the canal does not close, at birth, the increasing intra-abdominal pressure can force bowel loops into the scrotum determining inguinal hernia, which is a common pediatric disease [1, 2]. Prenatal inguinal hernia is a rare condition as intra-abdominal pressure in the fetus is similar to the pressure in the amniotic cavity. Therefore very few cases are described in the literature. In this paper we report a case of prenatal inguinal scrotal hernia, associated with contralateral hydrocele, diagnosed by ultrasound examination at 37 weeks of gestation. 2. Case Report A 30-year old woman, primigravida, was referred to the Fetal Medicine Clinic of our department at 37 weeks of gestation for evaluation of a fetal scrotal mass visualized on ultrasound. Previous obstetric ultrasound examinations at 12, 21, and 30 weeks had not shown any evident fetal abnormalities. Fetal karyotyping had not been performed. The ultrasound examination was performed using a 4.0–8.0?MHz multifrequency 3D transducer (Voluson 730 Expert, General Electric). Fetal biometry was within the normal ranges for the gestational age with normal biparietal
A Contralateral Complication of Extra-peritoneal Laparoscopic Inguinal Hernia Repair
Clark SE,Hanson M,Jacob S
Journal of Surgical Case Reports , 2010,
Abstract: A 63 year old female underwent an uncomplicated total extraperitoneal repair of a right direct inguinal hernia. One week later she presented with a strangulated left femoral hernia. We believe the dissection of the extraperitoneal space caused bleeding which tracked down through the femoral canal resulting in a femoral hernia. To date there are no reports of such a complication following total extraperitoneal inguinal hernia repair in the literature.
Laparoscopia y exploración del lado opuesto de la hernia inguinal en el ni?o
Prada-Silvy,Carlos E; Brice?o Iragorry,Leopoldo; Ordaz-Humbría,Irian;
Gaceta Médica de Caracas , 2006,
Abstract: la hernia inguinal es la patología quirúrgica más frecuente de la infancia. la incidencia de conducto peritoneo vaginal permeable del lado opuesto puede ser tan alta como el 25 % de los casos. se realizó un estudio en 75 pacientes con hernia inguinal unilateral utilizando la laparoscopia a través del saco herniario para la exploración del lado opuesto, en edades comprendidas entre 1 mes y 10 a?os. el 26 % de los casos fueron positivos para la exploración, independientemente de la edad. la exploración laparoscópica de la hernia inguinal opuesta es un método confiable, seguro, económico y de fácil realización, justificado para realizarse en los pacientes pediátricos con clínica de hernia inguinal unilateral independientemente de la edad.
Laparoscopia y exploración del lado opuesto de la hernia inguinal en el ni o
Carlos E Prada-Silvy,Leopoldo Brice?o Iragorry,Irian Ordaz-Humbría
Gaceta Médica de Caracas , 2006,
Abstract: La hernia inguinal es la patología quirúrgica más frecuente de la infancia. La incidencia de conducto peritoneo vaginal permeable del lado opuesto puede ser tan alta como el 25 % de los casos. Se realizó un estudio en 75 pacientes con hernia inguinal unilateral utilizando la laparoscopia a través del saco herniario para la exploración del lado opuesto, en edades comprendidas entre 1 mes y 10 a os. El 26 % de los casos fueron positivos para la exploración, independientemente de la edad. La exploración laparoscópica de la hernia inguinal opuesta es un método confiable, seguro, económico y de fácil realización, justificado para realizarse en los pacientes pediátricos con clínica de hernia inguinal unilateral independientemente de la edad.
IPSILATERAL INGUINAL HERNIA IN TODDLERS: IS IT NECESSARY TO EXPLORE OTHER SIDE?  [cached]
H.A DAVARI,B Surgical Department, School of Medicine, Isfahan University of Medical Sciences and Health
Journal of Research in Medical Sciences , 2001,
Abstract: Introduction: Inguinal hernia is one of the most common disease in pediatric surgery. Operation is the only definite treatment for it, yet. Bilateral inguinal exploration is recommended by some authors due to high incidence of bilateral inguinal hernia in children. Methods: In a cross sectional study 336 children (99 female and 237 male) with inguinal hernia were investigated. Contralateral exploration was done in all patients after repair of involved side. Data was categorized and analyzed according to sex and age. Results: Positive exploration in females and males was 76 and 62 percent, respectively. 44.3 percent of patients younger than one year old and 55.7 percent of patients between 1 to 3 years old had hernia in both sides. Sex and age correlated to coexisting of inguinal hernia in both sides (P < 0.03). Discussion: Contralateral exploration is more positive in lower age group. Contralateral exploration is recommended in ipsilateral inguinal hernia, specialy in girls with left sided hernia.
Comparing the Preoperative Ultrasound and Intraoperative Findings of Inguinal Hernia in Children.
Nazanin Eshraghi,Mohammad kazem Tarzamni,Mitra Khalili,Saeid Aslan abadi
Iranian Journal of Radiology , 2009,
Abstract: Introduction: Today, repair of inguinal hernia is one of the most common pediatric operations performed. Inguinal hernia is a type of ventral hernia that occurs when an intra-abdominal structure, such as the bowel or omentum, protrudes through a defect in the abdominal wall. Proper diagnosis and timed treatment of inguinal hernias are of very important significance. Considering the high prevalence of pediatric inguinal hernias, it is pivotal to employ an easily-performed, non-invasive and accurate modality for the diagnosis; and ultrasonography seems to fit the criteria. Also ultrasonography can be used as a tool for probing the contralateral probable hernias in unilateral cases. This study aimed at comparing the preoperative ultrasonography and intra-operative findings of inguinal hernia in children. "nMaterials and Methods: In a cross-sectional setting, children aged 0-14 years with the probable diagnosis of inguinal hernia referred to Tabriz Children's Hospital were recruited during a 24-month period. All the children were evaluated preoperatively with ultrasonography of the groin (with a linear 7.5 MHZ probe) at rest and during crying or upright position. The findings of ultrasonography of the affected side and the contralateral region were compared with the intra-operational findings. Accordingly, diagnostic efficiency of ultrasonography in children's inguinal hernias and probable involvement of the contralateral side was determined. "nResults: One hundred and twenty three patients, 106 males and 17 females with the mean age of 18.53±25.64 months (10 day to 12 years) were enrolled in the study. One hundred and eighteen (95.9%) patients underwent surgery and revealed to have a true inguinal hernia. The sensitivity, specificity, positive predictive value, negative predictive value and accuracy of preoperative ultrasonography was 97%, 98.8%, 99.4%, 99.1% and 97.6%, respectively. The specificity and accuracy of ultrasonography in the contralateral region was 94% and 91.3%, respectively. The concordance rate between the results of ultrasonography and intra-operative findings was high (kappa=.945, p<0.001). The sensitivity and positive predictive value of pre-operational ultrasonography were 95.7% and 100%, respectively for patients with positive clinical symptoms. "nConclusion: According to our results, ultrasonography is a safe and accurate modality for assessing the children with suspected inguinal hernia. For contralateral cases in unilateral hernia, the accuracy of this modality is considerable for ruling out the need of prospective
HISTORY OF INGUINAL HERNIA REPAIR  [PDF]
R. Van Hee
Jurnalul de Chirurgie , 2011,
Abstract: Inguinal hernia most probably has been a disease ever since mankind existed. In view of its existence in different kinds of animals, and in particular of primates, one can assume that already prehistoric human beings were affected with the disease. Inguinal hernia repair has made enormous progress throughout the ages. The main reasons for intervention however remained the same: continuous growth of the inguinal and/or scrotal swelling, the risk of incarceration of the hernia content and the bad results of conservative methods like truss placement. Surgical techniques have rapidly evolved since Eduardo Bassini proposed his first successful reconstruction of the inguinal floor. The various adaptations of his technique did however not result in a substantial reduction in the number of recurrences. The tension free repair, introduced by Irving Lichtenstein, caused a dramatic drop in the recurrence rate and became the procedure of choice. Since the introduction of laparoscopic techniques, these methods became equally accepted for inguinal hernia, in particular in western regions where financial aspects play a less prominent role. The future will tell how hernia repair will evolve in the next decades.
Age aspects of inguinal hernia relapses  [PDF]
Ostrovsky V.K.,Filimonchev I.E.
Saratov Journal of Medical Scientific Research , 2011,
Abstract: The research goal is to study an age role in relapses of inguinal hernias. Relapses of inguinal hernias in 113 patients have been investigated. It is established that the elder the patient the more frequent relapses of inguinal hernias occur. Causes of relapses of inguinal hernias development are age changes in the inguinal canal structure and the tissues that take place in its formation. The article concludes that causal factors of inguinal hernia relapses are age index and structure changes of inguinal canal. It points out that plasty of posterior wall of inguinal canal is considered as a preventive measure in case of inguinal hernia relapse
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